Stanford researchers find EHRs don't boost care quality

A pair of researchers at Stanford University, Palo Alto, Calif., has released results of a three-year study that indicates EHRs did little to improve the quality of care.

"There's a lot of enthusiasm and money being invested in electronic health records," senior author Dr. Randall Stafford said in a news release. "It makes sense, but on the other hand it's an unproven proposition. When the federal government decides to invest in healthcare technology because it will improve the quality of care, that's not based on evidence. That's a presumption."

Stafford is an associate professor of medicine at the Stanford Prevention Research Center. A seven-page article based on the study, "Electronic Health Records and Clinical Decision Support Systems: Impact on National Ambulatory Care Quality," appears online in the Archives of Internal Medicine.

In the new study, Stafford and former Stanford undergraduate student Max Romano, who is now a medical student at Johns Hopkins University in Baltimore, analyzed data from nearly 250,000 patient visits in 2005 through 2007. They looked at whether computerized, clinical decision-support tools in EHR systems improved the quality of care.

Their conclusions? There was "no consistent association between EHRs and CDS and better quality," according to the report. "These results raise concerns about the ability of health information technology to fundamentally alter outpatient care quality."

Why does Stafford think that's so?

"These are complicated systems used by individuals who have received little formal training, at least until recently," Stafford said in the release, adding that, as a consequence, physicians might not have made full use of them. Physician communication skills, their patients' health literacy and access to healthcare as well as the "pressures of outpatient practice and whether physician payment rewards good quality care,” all were factors, according to the release.